Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia

Abstract

Background The age at which parents or caregivers first develop concerns about their child’s development has significant implications on formal diagnosis and intervention. This study aims to determine the sociocultural factors that are associated with the age and type of first concern reported by parents of autistic children among culturally and linguistically diverse (CALD) communities in Australia. We also assessed whether sociocultural factors predict autism traits measured in terms of social affect (SA), restricted and repetitive behaviours (RRB), and calibrated severity scores (CSS). Methods This study is a secondary data analysis of the data collected from six Autism Specific Early Learning and Care Centres (ASELCCs) as part of the Autism Co-operative Research Centre (CRC) program between 2015 and 2019. Data analysed in this study included a family history questionnaire with sociodemographic and sociocultural information, parent-reported age and type of first concern, and clinician/researcher administered Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) which includes standardised domain-wise scores of social affect (SA) and restricted and repetitive behaviours (RRB) as well as calibrated severity scores (CSS), a measure of severity of autism. Primary analysis included multivariable linear regression models to examine the predictive influence of sociodemographic and sociocultural factors on the dependant variables of age of concern (AOC) and the autism traits (SA, RRB, and CSS). Results The mean AOC in the sample was 18.18 months and the most common concerns were speech/language delay, limited social interaction, and hyperactivity/behavioural changes. The multivariable linear regression models showed factors such as increase in age of child, those from a CALD background, annual family income, sibling’s autism diagnosis, and developmental concerns to be significantly associated with parental AOC. Additionally, we also found that increase in child’s age and CALD status to be significant predictors of autism trait (RRB) and severity measured in terms of the CSS score. Further, females (compared to males) were associated with higher difficulties with social communication and interaction skills. Conclusion Understanding key factors that contribute to early identification of autism can help tailor awareness programs for parents and caregivers, whilst also informing the development of services focused on serving all CALD communities.

Environmental risk factors for Autism

“…It has been noticed that, the majority of our ASD cases diagnosis was after 2 and 3 years of age. Which was reliable with that seen in Australia, where a study conducted on a larger sample of autistic cases, the average age of diagnosis was 28 months [13] . Another study done recently in 2022, in which 61% of children with autism were diagnosed between (3-6) years of age [9] .…”

Language Performance of an Eight-Year-Old Child with Speech Delay

“…The possible cause due to psychological factors of parents during pregnancy, psychological factors of children, the role of parents in the development phase of children's speech period, and the role of teachers and the environment in schools that help children in enriching vocabulary. Another reason for speech/language delay of children could be due to cultural beliefs of parents where speech delays are often normalised or overlooked (Hussain et al, 2023b).…”

Screening Tools for Autism in Culturally and Linguistically Diverse Paediatric Populations: A Systematic Review

“…Ou et al (14) found that even if the mother spoke English pro ciently, infants from culturally and linguistically diverse (CALD) communities were less likely to access health services and receive mental health interventions. A study by Hussain et al (15) found a signi cant link between CALD status and delayed age at which developmental concerns were raised, as well as higher severity of autism symptoms at the time of professional input. In this regard, a multicultural cohort study found an inverse care law in that those from the most disadvantaged backgrounds with the highest risk for developmental problems were least likely to engage with developmental Page 3/20 surveillance programs for early identi cation, thereby missing opportunities for early intervention (13,16).…”